The state Board of Health on Wednesday adopted significant new rules for Colorado’s small-scale medical-marijuana providers, over the objections of cannabis advocates who said the rules are too harsh.

The rules will require that caregivers — medical-marijuana providers serving five or fewer patients — do more than just give cannabis to patients. Instead, they must also do something extra, such as help patients with shopping, cooking or getting to doctor appointments.

Medical-marijuana advocates fear the added responsibilities will severely trim the number of caregivers, which state officials said Wednesday stands at 16,000. The advocates say caregivers provide a link to medical marijuana for patients who are poor, who can’t grow for themselves or who live in areas where there is no convenient access to dispensaries.

But Board of Health members said they do not think the regulations present the doomsday scenario that advocates worry they do.

“There’s a lot of things caregivers are already doing that would meet this definition,” the board’s president, Laura Davis, said at Wednesday’s hearing.

The rules will not affect dispensaries, which serve large numbers of patients and are regulated by separate laws. There are about 800 dispensaries in the state.

Caregivers are required by the state constitution to have a “significant responsibility for managing the well-being of the patient.”

What, exactly, that means has been the subject of a years-long debate, played out at the Board of Health, at the legislature and in the courts. The new rules are intended to settle the debate.

Law enforcement officials said the rules are needed to help them better differentiate between legitimate medical-marijuana caregivers and illegal drug dealers hiding behind the claim that they are caregivers. Neal Richardson, chief deputy district attorney in Denver, called such a clear separation “the linchpin in our enforcement efforts against people who are dealing drugs.”

With rules requiring that care givers do extra work for their patients, police could then ask purported caregivers about that work to help determine whether the caregivers are legitimate, said Ernie Martinez, the president of the Colorado Drug Investigators Association.

But medical-marijuana advocates said such an approach would allow law enforcement to intrude into patients’ medical care, and they questioned why state officials would want medical-marijuana caregivers providing services that others are better qualified to provide.

The advocates said the rules are a misunderstanding of why patients have caregivers.

“We’re looking at cultivators being required to do all of these other things when what we really want them to do is be cultivators,” said Shannon Gass, with the Grand Junction- based group Cannabis Consumer Health and Patient Advocacy Association.

Gass wondered whether care givers could simply help patients coordinate other aspects of their care — like transportation or cooking — rather than being directly involved in those things. Board members said they thought that would be enough to meet the new rules.

Still, a number of medical-marijuana advocates said the Board of Health was creating too great a burden for caregivers, many of whom say they work virtually for free.

“I make no money doing this,” said Michael Marcella, a caregiver from Colorado Springs. “I’m going broke doing this. I’m doing this because I care about people.”

The board approved the new rules unanimously. They will take effect next month.